社区规范管理稳定性冠心病患者运动耐量情况及其影响因素分析  

Exercise Tolerance and Its Influencing Factors in Patients with Stable Coronary Artery Disease under Standardized Community Management

作　　者：杨玲[1] 杜雪平[1] 董建琴[1] 董玉明[1] YANG Ling;DU Xueping;DONG Jianqin;DONG Yuming(Yuetan Community Health Service Center,Fuxing Hospital,Capital Medical University,Beijing 100045,China)

机构地区：[1]首都医科大学附属复兴医院月坛社区卫生服务中心,北京市100045

出　　处：《中国全科医学》2024年第1期51-58,共8页Chinese General Practice

基　　金：首都卫生发展科研专项(2018-3-7023)。

摘　　要：背景稳定性冠心病(SCAD)患者冠状动脉硬化狭窄、斑块破裂形成血栓的风险高,再发心血管事件概率高,是反复住院的重要原因。发达国家通过运动康复为主的心脏康复使得本国心血管疾病的发生率、死亡率、再入院率明显下降,医疗费用降低。目的调查首都医科大学附属复兴医院月坛社区卫生服务中心规范管理SCAD患者运动耐量及其影响因素,为后期社区心脏康复提供科学依据。方法2020年1月,通过整群抽样在首都医科大学附属复兴医院月坛社区卫生服务中心卫生信息系统(CHIS)(医生工作站)选取规范管理、75岁以下SCAD患者980例,采用自行设计问卷[包括一般资料调查表、退伍军人特定活动问卷(VSAQ)等]对其进行调查。依据VSAQ测得的代谢当量(METs)值者分为运动耐量≤7.0 METs组和运动耐量>7.0 METs组,比较不同运动耐量SCAD患者临床资料的差异,采用Logistic回归分析探讨SCAD患者运动耐量的影响因素。结果980例SCAD患者中,运动耐量>7.0 METs者108例(11.0%),5.0~7.0 METs者619例(63.2%),<5.0 METs者253例(25.8%);运动耐量≤7.0METs组SCAD患者的性别、年龄、PCI术接受情况、糖尿病患病情况、血压达标情况、规律运动情况、运动强度水平、每次运动时间与运动耐量>7.0 METs组比较,差异有统计学意义(P<0.05)。Logistic回归分析结果显示,性别、年龄、是否患有糖尿病、血压控制是否达标、是否规律运动、运动强度是SCAD患者运动耐量的影响因素(P<0.05)。结论SCAD患者有运动意识,但运动耐量整体水平较低(≤7.0 METs),缺乏运动指导,建议通过运动康复,提高运动耐量,从而改善其生活质量。Background Patients with stable coronary artery disease(SCAD)have a high risk of atherosclerotic stenosis of the coronary arteries,plaque rupture and thrombosis,and a high probability of recurrent cardiovascular events,which is the essential cause of repeated hospitalization.Cardiac rehabilitation mainly based on exercise rehabilitation in developed countries leads to a significant decrease in the incidence,mortality,and readmission rates of cardiovascular disease in these countries and reduces medical costs.Objective To investigate exercise tolerance and its influencing factors in the standard management of SCAD patients in Department of General Practice,Yuetan Community Health Service Center,Fuxing Hospital,Capital Medical University,so as to provide a scientific basis for future cardiac rehabilitation in community.Methods In January 2020,a total of 980 SCAD patients with standardized management under the age of 75 years were searched in the community health information system(CHIS)(doctor workstation)of Department of General Practice,Yuetan Community Health Service Center,Fuxing Hospital,Capital Medical University by using cluster sampling method.Self-designed questionnaires[including tools such as the General Information Questionnaire and the Veterans Specific Activity Questionnaire(VSAQ)]were used to investigate the patients.Based on the metabolic equivalents(METs)values measured by VSAQ,they were categorized into exercise tolerance≤7.0 METs group and exercise tolerance>7.0 METs group,and the differences in the clinical data of SCAD patients with different levels of exercise tolerance were compared.Logistic regression analysis was used to explore the factors influencing the exercise tolerance in SCAD patients.Results Among 980 patients with SCAD,108(11.0%)patients had exercise tolerance>7.0 METs,619(63.2%)had 5.0-7.0 METs,and 253(25.8%)had<5.0 METs.Gender,age,PCI acceptance,prevalence of diabetes mellitus,blood pressure attainment,regular exercise,exercise intensity level,and exercise time per session of S

关 键 词：稳定性冠心病 二级预防 运动耐量 运动康复 影响因素分析 

分 类 号：R541[医药卫生—心血管疾病]